Joslin 50 - Year Medalist Study

50 - Year Medalist Study Background

In 2003, Drs. George King and Hillary Keenan initiated 'The Joslin 50-Year Medalist Study', which is now known as 'The Medalist Study'. The Joslin Medalist Study was initiated in order to determine whether protective factors exist to prevent the development of severe complications such as retinopathy, nephropathy, and cardiovascular diseases in people with diabetes.

Protective factors against these terrible complications may exist in diabetic patients since previous anecdotal reports have indicated that in rare individuals who have had type 1 diabetes for more than 50 years, eye or kidney complications may not occur even with hyperglycemia.

This idea is very exciting since the findings of these protective factors can benefit millions of people with diabetes to prevent or stop the development of devastating eye and kidney complications. In order to determine and characterize these protective factors, The Joslin Medalist Study recruited over 1,000 people with type 1 diabetes and still living in the United States of America. Each Medalist's medical history and records were reviewed in order to assure that each individual have been insulin dependent for 50 years or longer.

Once the 50, 75, or 80 year Medals have been rewarded, each Medalist was invited to join the Medalist Study. This includes an extensive medical history questionnaire and clinical evaluation. The evaluation took pace at the Joslin Diabetes Center's Clinical Reasearch Center including physical exams, EKG, mixed meal tolerance test (MMTT) and complete eye examination. In addition, each Medalist Study was characterized by an extensive battery of laboratory tests involving plasma serum, urine, and circulation cells; including DNA analysis.

The Medalists responded with a high level of enthusiasm to this study wit more than 80% participation of the known Medalists who have received the Medal. Further, over 50% of the Medalists have agreed to donate their organs at passing.

The results from the initial studies have provided exciting information that 35% of the Medalists in the Medalist Study do not have significant eye, kidney, or nerve diseases; even in the presence of hyperglycemia for 50 years. These studies, reported in several highly cited articles in important journals, Diabetes Care (2007,2011) strongly support the idea that protective factors exist endogenously in the Medalists, which can neutralize the adverse effect of hyperglycemia in the eye, kidney, and possibly nerves.

In addition, these studies also showed very exciting new findings that a large number of Medalists still can produce insulin as measured by plasma level of C-peptide. This new finding has raised a possibility that factors may exist in people with T1DM, which can rejuvenate insulin producing beta cells, and can be therapeutically important for both type 1 and type 2 diabetic patients.P>

In 2010, Drs. King and Keenan began the longitudinal component of the Medalist Study, which invites each of the original 1,020 participants to return to Boston for a second set of studies to confirm the original findings and determine whether aging can affect the course of T1DM. Recent studies using the bio specimen obtained in circulating blood and targeted organs such as the eye and kidney have identified a profile of proteins that have the capability to prevent damages to the kidney.

Through a long and complex study, Dr. King's laboratory has potentially identified a set of proteins that could protect the various part of the kidney from being damaged by high blood glucose levels. This was published in one of the most prestigious scientific journal in the world, Nature Medicine in 2017. Further reports will be coming soon regarding the protective factors against the development of eye disease in individuals with diabetes.

At this time, we have started multiple new projects involving the Medalists. These other studies include the characterization of Medalists' beta cell functions to produce and secrete insulin, existence or lack of cognitive dysfunction, and osteoporosis, which are two of the major complications of aging diabetic patients. Another new study will be on the role of the gut bacteria to preserve the beta cell's ability to make insulin.

In addition, our newest endeavor is to characterize how the potential protective factors in the cardiovascular tissues that could be protecting the Medalists from heart disease with a seed grant from the Thomas Beatson Foundation. These studies have and will provide a wealth of information regarding patients with long duration type 1 diabetes and will have a huge impact on the development of new treatments, even a cure for diabetes and its complications.

We want to thank all the Medalists who have been awarded the Medal and those who have participated in our Study. By their enthusiasm in participating in the study, donation of bio specimens samples, and many other assistance that have been provided to us since 2003.

To learn more about the Medalist team, further updates about our work including some of our published data or to apply for a Medal and learn more about the Medal Program, please see the tabs to the left of this page.